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Postnatal Depression and IVF
There’s always a sense of relief when, as a professional, you begin to notice trends in your patients which have never been documented and then some time later evidence-based research is published which supports these observations. The relief stems from the fact that one’s observational skills remain acute enough to pick up new trends. This was the case with clients I have been working with post-delivery who had had IVF. I noticed that a very high number of these mothers exhibited signs of anxiety following the birth of their baby which increased as the weeks and months went by. Quite a high proportion of these mothers went on to develop postnatal depression.
Research published earlier this year showed a disproportionate number of women suffering from postnatal depression had their babies through IVF. Tracking more than 150 women who conceived using assisted reproductive technology through their first 18 months of motherhood, Melbourne University researcher Karin Hammarberg found IVF mums to be more anxious and lacking in confidence than those women who had conceived without treatment. The research also found that IVF mothers are 3 times more likely to be admitted to early parenting centres such as sleep schools, are more likely to have given up breast feeding and more likely to be disappointed with their birth experience.
Ask any woman who has undergone IVF or extensive infertility treatment how the experience was and they will invariably say “depressing, painful and expensive”. Months or even years of calendar watching, being in the right place at the right time, waiting for results and dreading periods takes its toll. You would think then, that after all of this stressful and emotionally exhausting experience, the arrival of the lovely new baby would bring joy, satisfaction and a sense of completeness. Often this is not so. Many women who have tried so hard to conceive have, understandably, very high expectations of life with their new baby. Once they have given birth and moved beyond the initial surges of euphoria and elation they can then feel overwhelmed and even burdened by the responsibility of caring for such a precious little life. It is also the case that their friends and families have higher than average expectations of them: “you must be so thrilled to finally have what you want”; “I’m sure it was all worth it”; “this is SUCH a precious baby” are all common comments made to the new parents. Yet life with a new baby is not easy for anyone. An IVF baby doesn’t behave any differently to other babies, it doesn’t think “I’m so lucky to be here, they’ve spent $$$$$$$$$ to get me, I must be good and grateful and not cry too much” nor does it think “I must be cute and adorable, come out smiling looking into their eyes”! The baby will be just like any other baby: demanding, selfish, hard work with a cry equivalent to the sound of a pneumatic drill. Yet the IVF mum seems to bear the added burden that she should respond to all these normal challenges with greater repose, with instant love, bonding and composure, despite the fact that many women struggle to achieve this.
Something else I have noticed is that because many women who have had IVF have complicated obstetric histories (and let’s not forget the frequent circumstance of giving birth to multiples, which is another story in itself). IVF mums tend to end up having Caesarean sections. Some of these women feel intensely disappointed by this, feeling unable to conceive in a natural way and then unable to deliver naturally they express feelings of failure that their bodies can neither conceive nor give birth without medical assistance. This can result in low self esteem and often spills over into their perception of motherhood, yielding a lack of confidence and trust in their maternal instincts.
Mothering really is a lot about confidence in the way a mother responds to the infant. It is also about having a realistic view of life with a baby. This means accepting that there will be really hard days when nothing you do will calm the baby, that some days the baby won’t seem to settle and that sometimes no one will have a clue why the baby is crying. It is also about accepting that sometimes the baby will look ugly (infant acne, sweat rash, birth marks, covered in puke) and that sometimes the baby will quieten for people other than the mummy (because they don’t smell of breast milk or because they are calmer because they are impartial and therefore less stressed). The challenges of motherhood for mums who have been through IVF are no different to any other mother. All mothers experience some days which are really hard and stressful and some days when they will feel so exhausted they could drop and days when they really long for their old life of routine and control and uninterrupted sleep. IVF mothers, like all mothers, should be encouraged to voice their anxieties and misery without being made to feel guilty and they should not be made to feel as if they should only feel gratitude for finally getting what they wanted. Moreover they should not feel bad about asking for advice or reassurance: it is completely understandable that they could feel even more anxious than the average mothers about the care of their baby because they have been through a roller-coaster of emotions during conception, pregnancy and delivery. Nor should IVF mothers feel required to perform as a perfect mother: “the perfect mother” does not exist.
If you feel are concerned that you may have post natal depression please do not be embarrassed about expressing this, at least 1:10 mothers suffer from it (and we think in HK the percentage is much higher). Post natal depression does NOT go away miraculously and can last the whole first year of your baby’s life. Women who have sought help often comment that they wished they had accepted treatment or counselling earlier because it had made such a huge difference to their family life. Please contact your health visitor, baby clinic, obstetrician, or GP for advice and treatment.
Yvonne Heavyside, Health Visitor, Lactation consultant
The Family Zone
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